| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
359 |
324 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
66 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
55 |
50 |
$6K |
| 90461 |
|
131 |
131 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
174 |
174 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$1K |
| 81003 |
|
64 |
64 |
$128.52 |
| 90633 |
|
18 |
17 |
$0.00 |
| 90670 |
|
28 |
28 |
$0.00 |
| 90686 |
|
66 |
66 |
$0.00 |
| 90647 |
|
17 |
17 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |